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Spermatogenesis: Fertile Ground for Contributing to Recurrent Implantation Failure?

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Recurrent Implantation Failure

Abstract

Despite a thorough work-up, the underlying cause remains unknown in a large proportion of cases with recurrent implantation failure. Sperm plays an incontrovertible role in initiating and maintaining a successful pregnancy. Thus, male factor evaluation could provide insight into the etiology of unexplained implantation failure. Sperm genetics and epigenetics are burgeoning areas in infertility research, providing new insights into the diagnosis and management of recurrent implantation failure. This chapter reviews the current evidence on sperm chromosomal aneuploidy and sperm DNA damage, with a focus on recurrent pregnancy loss and implantation failure. Potential causes of sperm DNA damage, including oxidative stress, and different diagnostic methods for detection of sperm DNA fragmentation are summarized. Roles of modifiable risk factors such as alcohol, smoking, varicocele, testicular heat stress, medications, and environmental toxins are discussed, and recommendations are made regarding potential therapeutic options and interventions. Finally, alternative and newer methods for sperm retrieval and selection for assisted reproductive technology are discussed, and opportunities for future assessment and treatment of male factors in recurrent implantation failure are covered.

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Abbreviations

ART:

Assisted reproductive technology

ASRM:

American Society for Reproductive Medicine

CGH:

Comparative genomic hybridization

FISH:

Fluorescent in situ hybridization

ICSI:

Intracytoplasmic sperm injection

IMSI:

Intracytoplasmic morphologically selected sperm injection

IVF:

In vitro fertilization

PGS:

Preimplantation genetic screening

RIF:

Recurrent implantation failure

ROS:

Reactive oxygen species

RPL:

Recurrent pregnancy loss

SCD:

Sperm chromatin dispersion

SCSA:

Sperm chromatin structure assay

SDF:

Sperm DNA fragmentation

TESA:

Testicular sperm aspiration

TESE:

Testicular sperm extraction

TUNEL:

Terminal deoxy-nucleotide transferase-mediated dUTP nick end labeling

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  1. Center for Reconstructive Urology and Men’s Health, Division of Urology, University of Utah, Salt Lake City, UT, USA

    Sorena Keihani MD, Jeremy B. Myers MD, FACS & James M. Hotaling MD, MS, FECSM

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  1. Reproductive Medicine Associates of NJ, Thomas Jefferson University, Basking Ridge, New Jersey, USA

    Jason M. Franasiak

  2. Reproductive Medicine Associates of NJ, Thomas Jefferson University, Basking Ridge, New Jersey, USA

    Richard T. Scott Jr.

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Keihani, S., Myers, J.B., Hotaling, J.M. (2018). Spermatogenesis: Fertile Ground for Contributing to Recurrent Implantation Failure?. In: Franasiak, J., Scott Jr., R. (eds) Recurrent Implantation Failure. Springer, Cham. https://doi.org/10.1007/978-3-319-71967-2_3

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